Abstract
Angiogenesis, the growth of new blood vessels from pre-existing vasculature has an obvious and essential role in soft and hard tissue repair. During the wound healing many potential angiogenic factors are released and may be found in circulating blood. The most important are basic fibroblast growth factor (bFGF) and vascular endothelial growth factor (VEGF).
Experimental data confirm the important role of VEGF and bFGF in wounds and bone healing. It was proved that heparin and its low-molecular derivatives may interfere with various steps of angiogenesis process. Enoxaparine (En) is frequently used as anticoagulant for prophylaxis of thromboembolic complications. The aim of this study was to evaluate in vivo angiogenic potency and VEGF and bFGF content of sera collected from 7 patients after hip surgery, treated for 14 days with 40 mg of En (Clexane, Aventis) daily. Evaluation of angiogenic activity was performed twice before surgery (before and 1 day after one En dose) and 14 days after surgery. Sera were injected intra-dermally to anaesthetized Bal/c mice and 72 hours later the number of newly-formed blood vessels was counted in dissecting microscope (SIA test). Cytokines concentration was estimated by ELISA. Results: Sera obtained after one En dose presented increase of angiogenic activity (57,3+/− 2,4, n=112, p< 0.01)in comparison to the value before En (44.6 +/− 2.5, n=113 of newly-formed blood vessels. After 14 En doses, further increase was observed (72 +/− 4.9 blood vessels, n= 112).
BFGF levels increased after the first En dose, VEGF concentration was significantly higher after 14 injections as compare to the results obtained before or after one injection of En.
Conclusion: Beneficial effect of 14-days prophylaxis with enoxaparine on healing process might be expected in patients after hip surgery.
Correspondence should be addressed to ERASS Office, Schulthess Klinik, Lengghalde 2, CH-8008 ZURICH, Switzerland.
